Rationing joint replacements: trust's decision seems to be based on prejudice or attributing blame...
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Health Care Rationing↗
Biomedical subjects
Nicholas Finer
Publications and source records attributed to Nicholas Finer.
Moderate exercise and fibrinolytic potential in obese sedentary men with metabolic syndrome.
OBJECTIVE: To investigate the impact of 30-minute walking exercise at 70% VO2max on tissue plasminogen activator (t-PA) Ag and plasminogen activator inhibitor type 1 (PAI-1) Ag in obese sedentary males. RESEARCH METHODS AND PROCEDURES: A controlled observational study of the effect of a 30-minute acute exercise bout at 70% VO2max on plasma t-PA antigen and PAI-1 antigen in 10 obese sedentary males matched for age, ethnic origin, and smoking status with 10 nonobese sedentary male controls. RESULTS: The obese group remained hypofibrinolytic compared with the nonobese group at all time-points before, during, and after exercise. t-PA increased in both groups with exercise before returning to baseline values 30 minutes after exercise. PAI-1 did not significantly change in either group with exercise but rose significantly 30 minutes after exercise in the obese group. DISCUSSION: The reduction in fibrinolytic potential in the obese group represents an increase in acute thrombotic risk and could account for the increased incidence of exercise-associated myocardial infarction observed in sedentary obese groups.
Adult↗
A 6-month randomized trial of thyroxine treatment in women with mild subclinical hypothyroidism.
PURPOSE: The role of thyroxine replacement in subclinical hypothyroidism remains unclear. We performed a 6-month randomized, double-blind, placebo-controlled trial to evaluate the effects of thyroxine treatment for mild subclinical hypothyroidism, defined as a serum thyroid-stimulating hormone level between 5 to 10 microU/mL with a normal serum free thyroxine level (0.8-16 ng/dL). SUBJECTS AND METHODS: We randomly assigned 40 women with mild subclinical hypothyroidism who had presented to their family practitioners to either thyroxine treatment (n = 23; 50 to 100 microg daily) or placebo (n = 17). Health-related quality of life (Hospital Anxiety and Depression scale, 30-item General Health Questionnaire), fasting lipid profiles, body weight, and resting energy expenditure were measured at baseline and 6 months. RESULTS: The most common presenting symptoms were fatigue (n = 33 [83%]) and weight gain (n = 32 [80%]). At presentation, 20 women (50%) had elevated anxiety scores and 22 (56%) had elevated scores on the General Health Questionnaire. Thirty-five women completed the study. There were no significant differences in the changes from baseline to 6 months between women in the thyroxine group and the placebo group for any of the metabolic, lipid, or anthropometric variables measured, expressed as the mean change in the thyroxine group minus the mean change in the placebo group: body mass index, -0.3 kg/m(2) (95% confidence interval [CI]: -0.9 to 0.4 kg/m(2)); resting energy expenditure, -0.2 kcal/kg/24 h (95% CI: -1.3 to 1.0 kcal/kg/24 h); and low-density lipoprotein cholesterol, -4 mg/dL (95% CI: -23 to 15 mg/dL). There was a significant worsening in anxiety scores in the thyroxine group (scores increased in 8 of 20 women and were unchanged in 2 of 20) compared with the placebo group (scores increased in 1 of 14 women and were unchanged in 6 of 14; P = 0.03). CONCLUSIONS; We observed no clinically relevant benefits from 6 months of thyroxine treatment in women with mild subclinical hypothyroidism.
Anthropometry↗